**1. Introduction**

Obesity is an epidemic in developed countries. The obesity epidemic is increasing its magnitude and its public health impact. In 2017–2018, 67% of the population in Australia were overweight or obese [1]. In the United States, only minority of the individuals have a healthy weight (body mass index (BMI) of 18.5–25 kg/m<sup>2</sup> , [2]. Furthermore, according to the World Health Organization (WHO), nearly 2 billion adults are overweight and more than 600 million patients are obese [3]. Type 2 Diabetes (T2D) is one of the chronical diseases associated with Obesity. T2D is usually characterized by insulin resistance (IR) [4]. Insulin resistance (IR) happens when the body does not fully respond to insulin. IR level can be used as a filtering index for primary T2D prevention.

IR can be measured by using the homeostatic model assessment of insulin resistance (HOMA-IR) equation. HOMA-IR can be evaluated by fasting glucose and insulin levels. People with T2D commonly have High HOMA-IR score, which indicates significant insulin resistance [5–7].

As little as 3% weight reduction produces clinically significant effects to reduce HOMA-IR [8, 9]. The most widely prescribed strategy to induce weight loss is to reduce the daily calory intake [10]. Current guidelines recommended continuous energy restriction (CER) along with comprehensive lifestyle intervention, as the cornerstone of obesity treatment [11]. For some individuals CER are effective for weight loss. However, many people realize that this type of diet is difficult to follow, as it requires robust calorie counting, and frustration is caused be owing to the feeling of never being able to eat freely.

There has been increased interest in identifying alternative dietary weight loss strategies, because of the relative ineffectiveness of traditional CER approaches for achieving and sustaining weight loss. One such approach is intermittent fasting (IF) also called intermittent energy restriction (IER) which encompasses various diets that cycle between periods of fasting and no fasting, these diets do not necessarily specify what to eat. The regimens of IER may be easier to follow and maintain over time than CER. Furthermore, people do not fully compensate during fed periods for the lack of energy created during prolonged periods of fasting. Therefore, IER may lead to metabolic adjustments that prefer greater fat mass loss, better maintaining of lean mass, and weight loss [12–13].

The IER regimens range from fasting the whole days at a time to fasting for several hours during the day. IER paradigms involve recurring periods with little or no energy intake with intervening periods of ad libitum food intake. The two most popular forms of IER are: the 5: 2 diet characterized by two consecutive or non-consecutive "fast" days and the alternate-day energy restriction, commonly called alternate-day fasting (ADF). The second form is time-restricted feeding (TRF), eating within specific time frames such as the most prevalent 16: 8 diet, with 16 hours of fasting and 8 hours for eating.

Previous studies and systematic reviews provide an overview of IER regimes [14–34]. Those studies report the health benefits leading by IER regimes and discuss the physiological mechanisms by which health outcomes might be improved [35]. However, the question of whether IER is always able to reduce HOMA-IR is not answered by the latter studies; In other words, what are the conditions (age, gender, basal fasting glucose level, etc.) needed to make the IER effective for reducing HOMA-IR have not yet been deciphered. Moreover, results of previous studies are reported on a group level only rather than report per individual.

In today's era of precision medicine, we can be motivated to answer the question Can we predict who will be Successful on an IMF or TRF Diet or CER? For example, a patient with prediabetes or diabetes comes to see his physician to ask for advice. Could such patient benefit from a specific IF intervention? Benefit in terms of reducing HOMA-IR or even eliminating the T2D altogether. A recommendation system which suggest effective IF intervention for a certain patient is found in a new study [36]. The recommendation system is based on individual data from human fasting intervention studies. The system presented in the study, predicts which type of IF treatment can improve an individual's health and preventing or curing T2D. A machine learning approach is used to develop the recommendation system while a set of rules which can assist individual patients and their physicians in selecting the best IF intervention is provided by the results of the study.

A further question will be discussed in this chapter: Can we predict the optimal intervention IMF or TRF Diet or CER or other for a prediabetes patient? and what is the accuracy of such prediction?

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*Selecting Intermittent Fasting Type to Improve Health in Type 2 Diabetes: A Machine Learning…*

Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar). Our metabolism converts food into energy for our bodies to use. One of the things needed for this process is insulin. The pancreas makes a hormone called insulin. The insulin helps the cells turn glucose from the food we eat into energy. After we eat, the sugar levels in our blood rise and insulin is released into the bloodstream. The insulin then makes the cells absorb sugar from the blood. If this process does not work properly, the blood sugar levels rise. The medical term

According to the International Diabetes Federation in 2017 there were 425 mil-

There are two main types of diabetes: type 1 and type 2. Glucose gives the body cells energy, but to enter the cells it needs insulin. People with type 1 diabetes do not produce insulin; while people with T2D do not respond to insulin as well as they should. Both types of diabetes can lead to chronically high blood sugar levels. Type 1 diabetes usually develops in childhood or teenage years. This disease is a result of damage to the pancreas that leaves it producing either very little insulin or none. Type 1 diabetes is caused by an autoimmune reaction where the body's defense system attacks the cells that produce insulin. Things are different in T2D, where insulin is made by the pancreas, but the body's cells lose the ability to absorb and use the insulin. In people who have T2D, the pancreas produces enough insulin, but it no longer influences the body's cells. The medical term for this is "insulin resistance" (IR). The pancreas can compensate for this for a while by producing more insulin. But at some point, it can no longer keep up, and then blood sugar levels start to rise. T2D is characterized by (IR), where the body does not fully respond to insulin. In the past, T2D was often referred to as "adult-onset" diabetes because it is commonly diagnosed later in life. T2D is much more common than type 1 diabetes. Among all the people living with diabetes, 90–95% percent have T2D. This chapter focuses on T2D.

Usually, a combination of things causes T2D. There are several gene mutations linked to diabetes. Not everyone who carries a mutation will get diabetes. However, many people with diabetes do have one or more of these mutations. Being overweight or obese can cause IR. People with insulin resistance often have a group of conditions commonly called "Metabolic syndrome", including high blood sugar, extra fat around the waist, high blood pressure, high cholesterol and high triglycerides. Another cause can be bad communication between cells. Sometimes, cells send the wrong signals or do not pick up messages correctly. When these problems affect how cells make and use insulin or glucose, a chain reaction can lead to diabetes. Finally, broken beta cells can cause diabetes since if the cells that make insulin send out the wrong amount of

Various factors can increase the likelihood of developing T2D. They can be described using 3 categories. The category of risk factors is who you are: age of 45 or older, a family relative with diabetes or ethnicity. The second category is health and medical history: being prediabetes can increase the risk for diabetes, heart and blood vessel disease, high blood pressure, low HDL ("good") cholesterol, high triglycerides, being overweight or obese, Gestational diabetes while you were pregnant and finally depression. The last category of risk factors is the daily habits

insulin at the wrong time, blood sugar is not controlled properly.

lion people in the world with diabetes. That is close to 1 in 11 people [37].

*DOI: http://dx.doi.org/10.5772/intechopen.95336*

for blood sugar levels that are too high is hyperglycemia.

**2. Type 2 diabetes (T2D)**

**2.1 Main types of diabetes**

**2.2 Causes and risk factors**

*Selecting Intermittent Fasting Type to Improve Health in Type 2 Diabetes: A Machine Learning… DOI: http://dx.doi.org/10.5772/intechopen.95336*
